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The Beyond Pain Foundation

Conditions we support

Conditions guide

Long COVID

Long COVID is when symptoms carry on for weeks or months after a COVID-19 infection. Extreme tiredness, breathlessness, aching joints and muscles, and brain fog are common. This guide explains the symptoms, how doctors assess it, the support available in the UK, and your rights at work.

People in England and Scotland reporting it (2024)
About 2 million
Say it affects their day-to-day life
About 3 in 4
Have had it for a year or more
About 7 in 10
Called post-COVID-19 syndrome after
12 weeks

This guide is general information, not medical advice. Medicines and treatments must be prescribed or recommended for you by a doctor or pharmacist. We do not give doses here.

What long COVID is

Most people get over COVID-19 within a few weeks. For some, symptoms go on much longer, or new ones appear. This is known as long COVID. Doctors may also call it post-COVID-19 syndrome.

It is still a fairly new condition and research is ongoing. It can follow a mild infection as well as a severe one. You do not need to have had a positive COVID test to be assessed for it.

In early 2024, the Office for National Statistics estimated that about 2 million people in England and Scotland had long COVID. Around 3 in 4 of them said it affected their day-to-day activities, and about 1 in 5 said it limited them a lot.

Long COVID has a lot in common with ME/CFS, especially the way symptoms can crash after activity. Our ME/CFS guide may also be useful.

How it can show up

There aren't official types of long COVID. It can affect many parts of the body. You may recognise more than one of these.

Fatigue and crashes

The most common problem. Deep tiredness that rest doesn't fix. Symptoms may get much worse a day or two after doing too much.

Breathing and heart

Breathlessness, a cough, chest tightness or a racing or pounding heart. Some people feel dizzy or faint when they stand up.

Brain fog

Problems with memory, concentration and finding words. It can make reading, screens and meetings very tiring.

Pain

Joint pain, aching muscles, headaches and chest pain. Some people get pins and needles or nerve-type pain.

Sleep and mood

Trouble sleeping, anxiety and low mood. Living with a long illness is hard, and these deserve support too.

Mild to severe

Some people keep working with small changes. Others are housebound for a time. Symptoms often come and go.

Symptoms and time frames

The NHS says the most common symptoms are extreme tiredness, shortness of breath, joint pain and aching muscles, and brain fog. Others include chest pain, palpitations, dizziness, tinnitus, changes to taste or smell, stomach problems, rashes, hair loss, headaches, and trouble sleeping.

UK guidance uses these time frames from when your COVID-19 symptoms started:

  1. Up to 4 weeks

    Acute COVID-19

    The infection itself. Most people start to feel better during this time.

  2. 4 to 12 weeks

    Ongoing symptoms

    Called ongoing symptomatic COVID-19. You can be referred for assessment from 4 weeks.

  3. More than 12 weeks

    Post-COVID-19 syndrome

    Symptoms that carry on and aren't explained by something else. Many people call both of these stages long COVID.

  4. Months to years

    Recovery

    Recovery time is different for everyone. Many people improve slowly, often with ups and downs.

Recovery timings vary a lot from person to person. They are a rough guide, not a rule.

Crashes after activity

Many people find their symptoms flare after physical, mental or even social effort. This is called post-exertional symptom exacerbation (PESE). It often starts 12 to 48 hours after the activity and can last days or weeks. Keeping a diary helps you spot your limits. Pacing, explained below, can help prevent crashes.

When to get urgent help

New or worse symptoms should never just be put down to long COVID. Some need checking quickly.

Call 999 or go to A&E if you have

  • chest pain, or pain spreading to your arm, jaw or back
  • sudden, very bad breathlessness, or lips or skin turning blue or grey
  • sudden weakness or numbness on one side, or trouble speaking
  • collapsed or fainted and can't be woken properly
  • thoughts of ending your life and feel you may act on them

Call NHS 111 if

  • your breathing is getting worse
  • your heart is racing or pounding and it doesn't settle
  • you are in a mental health crisis. In England, call 111 and choose the mental health option (option 2)
  • you need help and your GP is closed

See your GP if

  • you still have symptoms 4 weeks or more after COVID-19
  • you feel dizzy or faint when you stand up
  • your symptoms are getting worse or changing
  • you feel low or anxious most days

A long illness can be very hard to live with. If you are struggling, you can talk to Samaritans any time, day or night, free on 116 123.

Diagnosis and referral

There is no single test for long COVID. Your GP will ask about your symptoms, when they started and how they affect your life. A phone or video appointment may be offered if travelling is hard.

Tests are used to rule out other causes and check for problems that need treating. NICE guidance (NG188) and the NHS say these may include:

  • Blood tests, such as a full blood count and thyroid, kidney and liver checks
  • Blood pressure and heart rate, lying down and then standing up, if you get dizzy
  • Oxygen levels and heart rate during a short exercise test, such as standing up from a chair repeatedly for 1 minute
  • A chest X-ray by 12 weeks if breathing problems continue
  • An ECG (heart tracing) if you have chest pain or palpitations

Your GP may refer you to a post-COVID service from 4 weeks after your illness started. Normal test results do not mean your symptoms aren't real.

Treatment and rehabilitation

There is no cure yet, and NICE says there are no proven treatments for long COVID itself. Care focuses on managing symptoms, supported self-management and a rehabilitation plan made with you.

Personal rehabilitation plan

Post-COVID service or GP

A plan built around your symptoms and goals. NICE says rehabilitation should be personal and led by you, with regular check-ins on how you are coping.

Physiotherapy

NHS or private physiotherapist

Help with breathing, strength and building activity back up. It should be guided by your symptoms and slowed down or paused if you crash.

Occupational therapy

Post-COVID service, GP or employer

Practical help with fatigue, pacing, daily tasks and getting back to work. They can also advise on equipment.

Talking therapies and cognitive rehabilitation

NHS Talking Therapies (self-referral in England) or post-COVID service

Support for anxiety, low mood and coping with a long illness. Cognitive rehabilitation offers strategies for memory and concentration problems.

Treating specific problems

GP or hospital specialist

If tests find a particular problem, such as a heart, lung or blood pressure issue, your doctor can treat it in the usual way.

Be careful with exercise

Pushing through fatigue can make long COVID worse if you get crashes after activity. World Physiotherapy advises that graded exercise therapy, or fixed exercise plans that increase on a set schedule, should not be used for people with these crashes. Activity should be adjusted to how you feel.

NICE notes there is not enough evidence that vitamins or supplements help recovery. Talk to a doctor or pharmacist before taking anything new, and be wary of costly treatments that promise a cure.

Specialist options

  1. Post-COVID service

    From 4 weeks after your illness

    These teams may include doctors, physiotherapists, occupational therapists and psychologists. Since April 2024 they have been run by local NHS bodies rather than funded centrally, so what is offered varies by area, and some have changed or closed. Ask your GP what is available locally.

  2. Hospital specialists

    If tests show a specific problem

    You may be referred to a heart, lung or nerve specialist to look into particular symptoms.

  3. Fatigue or pain services

    If symptoms carry on

    Some areas have fatigue services, often shared with ME/CFS, or pain clinics. These can help with pacing, sleep and managing pain day to day. Your GP needs to refer you.

Self-help and pacing

Pacing your energy

  • Plan, pace and prioritise: decide what must be done and what can wait
  • Break tasks into short chunks with rests in between
  • Count mental and social effort, not just physical effort
  • Stop and rest before you feel wiped out, even on good days

Sleep and mind

  • Keep regular times for going to bed and getting up
  • Try gentle breathing exercises if breathlessness is a problem
  • Use lists, alarms and notes to help with brain fog
  • Join a support group so you don't feel alone

A symptom diary can show patterns, such as which activities lead to a crash a day or two later. It is also useful to take to appointments.

Getting the best care

Before and during appointments

  • Note when your COVID-19 symptoms started, even if you never had a positive test
  • Keep a simple diary: symptoms, sleep, energy and what you did the day before
  • Write down your top 3 questions before you go
  • Explain what you can't do any more, such as working full days or climbing stairs
  • Mention any crashes after activity and dizziness when standing
  • Ask: "Can you refer me to a post-COVID service, and what tests do I need?"
  • Bring someone with you to take notes if brain fog makes it hard to remember

If you don't feel listened to, you can see another GP at your practice, or ask for a second opinion. Long COVID is a recognised condition with NHS guidance.

Long COVID and work

Long COVID can count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland). This is decided case by case. It applies if it has more than a minor effect on your daily life and has lasted, or is likely to last, at least 12 months. Conditions that come and go can count.

If so, your employer must make reasonable adjustments. Even if not, Acas encourages employers to be flexible. Adjustments might include:

  • A phased return with fewer hours at first
  • Working from home some or all of the time
  • Regular rest breaks and a quiet space
  • Flexible start and finish times
  • Fewer meetings and less screen time
  • Written instructions to help with brain fog
  • Time off for appointments
  • An occupational health assessment

Equipment can save energy. Examples include an ergonomic chair, a sit-stand desk or perching stool, a monitor arm, a headset, and voice recognition software to cut down on typing.

Access to Work is a government grant that can pay for equipment, support workers and travel to work. For advice on your rights, contact Acas or Citizens Advice.

Benefits

If you can't work because of your symptoms, you may get Statutory Sick Pay from your employer for up to 28 weeks. You may also be able to get Personal Independence Payment (PIP), or Adult Disability Payment in Scotland, whether or not you work. Depending on your situation, Universal Credit or Employment and Support Allowance may help. Long Covid Support has guidance on work and money, and Turn2us and Citizens Advice can help you check what you can claim.

How The Beyond Pain Foundation can help

If NHS waits are too long, or the help you need isn't available to you on the NHS, we may be able to fund:

  • A private consultation with a specialist to look into your symptoms
  • Physiotherapy or occupational therapy that adjusts to your symptoms
  • Help planning a safe, phased return to work
  • Workplace or home equipment, such as an ergonomic chair, sit-stand desk or perching stool
  • Equipment that saves energy, such as voice recognition software or a headset

We fund treatment and equipment, not everyday living costs such as rent or bills. Treatment must be from a registered or qualified practitioner. Prices vary, so always get a written quote to include with your application.

Apply for funding Check the requirements

Support and sources

Long Covid Support

Charity and peer support

A large online peer support community, plus information on symptoms, work and money, and ways to take part in research.

longcovid.org

Acas

Free work advice

Clear guidance for employees and employers on long COVID, sick pay, adjustments and phased returns.

acas.org.uk/long-covid
Sources for this guide

Last reviewed: October 2026.